Dr Peter Carter said nurses who had trained in Eastern Europe were "astonished" by the priority the NHS places on paperwork, and by the number of elderly patients admitted to hospitals suffering from bedsores - which had gone unnoticed either by their families or by staff in care homes.

The General Secretary made the comments in an interview with The Sunday Telegraph, in which he said nurses from overseas were contributing a great deal to Britain's health service, while often being unfairly maligned for the quality of their work.

He said nurses from outside Britain had offered him valuable insights into both the culture of its health service, which they said had too much paperwork, and by and how Britain treats its elderly.

Dr Carter asked nurses who had come from Romania about the differences that struck them about working in this country as he visited a hospital.

"The first thing they said was that they are astonished by the amount of paperwork," he said.

"They said they would never ever have dreamt they would spend so much time just writing things down."

"The second thing was about the number of people that come into hospital with pressure sores. They had never seen the like of it.

"Some of it is elderly frail people coming from their own homes - in some cases it was from other residential establishments. They said that really took them by surprise - that was their honest appraisal."

Dr Carter said the cases emerging from care homes were a symptom of growing problems in the sector, which he said made far too much use of untrained assistants, liable to miss alarm bells warnings of deteriorating health.

"There are plenty of homes that provide good care ... but clearly there are problems emerging and in some areas they are having difficulty maintaining standards," the senior nurse said.

"There is no doubt that many of them have a massive over-reliance on healthcare assistants.

"In a care home we believe even the most junior healthcare assistants should have mandatory training, in relation to the care of the elderly, and to understand the early warning signs of pressure sores, and to see that as an immediate alert - but the average healthcare assistant will not think like that," he said.

The senior nurse said yet more cases emerged from frail elderly people living on their own, with relatives were often simply not aware that their loved ones were developing sores which could endanger their health.

"I'm not criticising the families, often people live hundreds of miles away," said Dr Carter.

"What you need is more infrastructure and help in the community. When you have got someone living on their own, sitting in a chair or in bed hour after hour on their own, they are more vulnerable to pressure ulcers and falls," he said.

Dr Carter said the staff from Romania spoke very positively about several other aspects of the NHS, but that their concerns deserved serious debate.

Nurses from other countries in Europe had also raised important issues with him, he said, such as a reluctance within Britain's health service to involve families in the patient's care, he said.

"In Spain, families are at the heart of care, and they are expected to attend the case conference, so they know what is going on, and can give input," he said.

"That happens in some places, but not often enough here," he said, describing how families had been locked out of even the most crucial decisions, such as whether to resuscitate a a patient.

A new report published by the RCN claims the NHS is heading for "crisis point," with more than 56,000 health service jobs due to be axed, as part of NHS "efficiency savings".

Analysis by the nurses' union suggests that half of the posts which have been identified for cuts are clinical jobs, with nurses' posts accounting for one in three of the cuts planned.

Although the Government has pledged not to cut overall health spending, rising demand from an ageing population means the service is trying to identify £20 bn "efficiency savings" to cope with the extra needs.

Dr Carter said: "We have always accepted that savings need to be made in the NHS, but cutting frontline staff and services that vulnerable patients rely on is just not the way to do it."

Health Minister Simon Burns said the Government did not recognise the figures, which he dismissed as "typical trade union scaremongering."